Abstract

Background: In December 2013, Health Ministers from G8 countries declared their commitment to tackle the increasing burden of dementia by calling for innovation and international partnership to strengthen health and social care systems. In 2009, already 14 million people across OECD countries were estimated to be suffering from dementia. By 2050, this is expected to rise to 100 million people. Annual global dementia costs are already estimated to amount to $604 billion (The Lancet Neurology; Prince, M., Prina, M., Guerchet, M., 2013:7). The growing number of dependent elderly people puts pressure on the labour market, the provision of health and social care as well as on public and private expenditure. In the Netherlands, where 11.9% of GDP were spent on health care in 2009, 5.8% of health spending was allocated for dementia alone (OECD Health Statistics, 2013). In response to the growing burden of dementia and the G8 declaration, this study examines innovative care models and best practices across OECD countries where gaps in dementia care services and knowledge have been addressed. This international comparative study of dementia policies will provide insightful information to countries in their efforts to provide seamless care to the specific needs of dementia patients.

Methods: International, national and regional policy documents and data on a range of key dimensions have been reviewed and analysed to provide a comparison of policies aimed at ensuring improved care pathways for people with dementia. A literature review is also conducted to provide background information about dementia. The study builds upon a series of studies undertaken by the OECD on dementia care, care co-ordination, long-term care financing and workforce and quality of long-term care.

Findings and recommendations: The preliminary findings show that countries are placing a greater emphasis on ensuring seamless care pathways for people with dementia while also making conscious efforts to strengthen overarching factors, such as building data infrastructure, supporting informal carers, improving the knowledge of health professionals and social care workers, to ensure the quality of dementia care. The United Kingdom, France, Germany, Japan and Australia have stated the goal of increasing early dementia detection rates by sensitising and 47 providing training to primary care providers, hospital doctors and the general public. People with dementia are 2–3 times more likely to be hospitalised compared to people without dementia although the lack of appropriate care in hospitals remains an issue. At the same time, the proportion of long-term care provided at home has increased by 20% in Japan, Germany and France over a 10-year period (OECD, 2013). However, prolonging the stay at home for people with dementia increases the burden on informal carers. Over the course of its national dementia plan 2008–2012, France invested €169.5 million into providing adequate respite care.

The importance of quality of care for dementia sufferers has been recognised and countries are working towards dementia-specific responses. Yet, countries are still need to scale up their efforts to achieve effective quality care for the dementia population by strengthening preventive activities, early diagnosis, home care services and palliative care.

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